Healthcare Provider Details

I. General information

NPI: 1649932948
Provider Name (Legal Business Name): BYRON HUNTER TATSCH NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 N VERCLER RD STE 5
SPOKANE VALLEY WA
99216-1092
US

IV. Provider business mailing address

801 SW 16TH ST STE 121
RENTON WA
98057-2628
US

V. Phone/Fax

Practice location:
  • Phone: 509-381-4500
  • Fax: 509-381-4501
Mailing address:
  • Phone: 206-538-6300
  • Fax: 206-538-6301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP61202171
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: